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Characteristics of Accidental Falls Among Elderly People in a Rural Area of Japan

Katsuhiko Takatori, Department of Physical Therapy, Kio University; Yohei Okada, Koji Nagino, Kentaro Tokuhisa, Koki Ikuno, Department of Physical Therapy, Nishiyamato Rehabilitation Hospital; Koji Shomoto, Department of Physical Therapy, Kio University, Japan

Objective: The purpose of this study was to investigate characteristics of accidental falls and related risk factors among elderly people in a rural area of Japan.

Participants: Seventy elderly people age 65 and older (mean age 75.7, range 65-94) living in a rural area of Japan.

Measurements: Physical examinations and questionnaires were used to identify the risk factors for falls between faller and nonfaller groups. Maximal grip strength, timed up-and-go test, Activity Balance Confidence (ABC) Scale, habitual exercise, farm work, chronic pain, assistive device use, the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence, and dizziness were assessed. Falls data and fall-related-injury data for the previous year were self-reported. The data were analyzed using the chi-square test, the t test, multiple logistic regression, and Pearson’s product-moment correlation coefficient.

Results: Twenty-three participants (32.9%) experienced accidental falls during the previous year. Twelve participants (17.1%) suffered fall-related injuries (bruise or wounds, 6 persons; fracture, 6 persons). When participants were divided into two groups (fallers and nonfallers), chi-square tests revealed significant group differences for those over 75 years old (73.9%), the presence of chronic pain (87.0%), and assistive device use (43.5%; all p < .05). The prevalence of falls was significantly smaller in participants who had done farm work (39%) than in those who had not (p < .05). There were no differences in the ABC score, maximal grip strength, TUG, dizziness, habitual exercise, and TMIG index of competence between fallers and nonfallers. However, participants who suffered fractures had significantly lower ABC scores than those who had not. In conclusion, from multiple logistic-regression analyses, farm work (odds ratio [OR] = 0.1, 95% confidence interval [CI] :0.02-0.8, p < .05), the presence of chronic pain (OR: = 7.8, 95%CI: 1.2-52.0,p < .05), assistive device use (OR = 19.9, 95%CI: 2.1-187.0, p < .01), and lack of habitual exercise (OR = 8.0, 95%CI: 1.5-42.6, p < .05) emerged as influences and factors in fall. Furthermore, the ABC scores of farm workers were significantly higher than those of nonrural workers and significantly correlated with TMIG index of competence (r = .4, p < .05).

Discussion and Conclusions: Fall incidence rate and injury rate were similar to previous study in urban area of Japan. However, what seemed to be specific to rural areas was that farm workers had fewer falls and higher self-efficacy. These findings have important implications for prevention of fractures in rural elders.


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